Advanced Airway

Question 1

What size ET tube do you use for a woman? A man?

Answer 1

7-8 7.5-8.5

Question 1

name the top 3 medications used prior to intubation.

Answer 1

Midazolam (Dormicum) Diazepam (Valium) Ketamine

Question 2

What devices may be used to intubate more easily?

Answer 2

Laryngeal mask airway (LMA) and combitube

Question 3

What is different about the combitube?

Answer 3

Two lumens - larger one usu. goes into esophagus.

Question 4

What dose of aspirin do you give immediately for ACS?

Answer 4

160-325 mg

Question 5

What are contraindications to nitroglycerin therapy? (give 4)

Answer 5

SBP <90 RV infarct severe brady- or tachycardia use of phosphodiesterase inhibitors

Question 6

What is the antidote for morphine?

Answer 6

naloxone

Question 7

Identify the condition from this EKG.

Answer 7

myocardial ischemia

(prominent T wave)

Question 8

Identify the condition from this EKG.

Answer 8

Acute myocardial infarction (STEMI)

Question 9

Identify the condition from this EKG.

Answer 9

myocardial injury (stable angina or MI)

Question 10

What leads indicate an inferior MI?

Answer 10

II, III, and aVF

Question 11

What leads indicate a septal infarct?

Answer 11

V1 and V2

Question 12

What leads indicate an anterior infarct?

Answer 12

V3 and V4

Question 13

What leads indicate a lateral infarct?

Answer 13

II, aVL, V5, and V6

Question 14

What is the (non-renal) mechanism of ACE-I therapy post-MI aside from lowering vascular resistance?

Answer 14

Prevents LV remodeling by inhibiting tissue ACE.

Question 15

Where do the thrombi of ischemic strokes usually originate?

Answer 15

Left atrium

Question 16

How could a DVT cause an ischemic stroke?

Answer 16

If there were a cardiac septal defect (or PDA?).

Question 17

What is a sign of carotid artery atherosclerosis on physical examination?

Answer 17

carotid bruits

Question 18

What tx would you consider in a patient w/ symptomatic persistent tachycardia due to atrial flutter or atrial fibrillation?

Answer 18

synchronized cardioversion

Question 19

What tx would you consider in a pt w/ persistent, symptomatic tachycardia w/ regular, narrow QRS complexes?

Answer 19

adenosine

Question 20

What dose of cardioversion is req’d for unstable VT?

Answer 20

100j

Question 21

What dose of cardioversion for unstable A-fib or A-flutter?

Answer 21

200j (monophasic) (or 120-200j biphasic)

Question 22

If adenosine fails for converting an irregular, pulse-generating, wide-QRS rhythm to a normal rhythm, what do you do next?

Answer 22

Not cardioversion! beta- or Ca++ channel blockers.